To evaluate the clinical utility of 123I-(rho-iodophenyl)-3-R,S-methylpentadecanoic acid (123I-BMIPP) for ischemic heart disease, we investigated the metabolic fate of 123I-BMIPP in canine models with mild and severe ischemia and evaluated the clinical utility of this tracer. METHODS: Using open-chest dogs under anesthesia, we assembled a system that would release all ...

Myocardial ischemia identified by ambulatory electrocardiography (AECG), exercising treadmill testing, (ETT), or 12-lead electrocardiogram at rest is associated with an adverse prognosis, but the effect of improving these ischemic manifestations by treatment on outcome is unknown. The Asymptomatic Cardiac Ischemia Pilot (ACIP) study was a National Heart, Lung, and Blood ...

The primary critical ischemia time of the hairless mouse ear was determined using a probit analysis. An atraumatic clamp was used across the pedicle base of the ear to induce total ischemia at 0, 2, 4, 6, 7, 7.5, 8.0, 8.5, 9.0, 9.5, and 12 hours of normothermic ischemia. Seventy-seven ...

Acetylsalicylic acid often is used in the treatment and prophylaxis of regional myocardial ischemia and infarction. However, only little is known about its electrophysiological effects and on possible proarrhythmic effects of the drug. Thus, the aim of this study was to evaluate the electrophysiological effects of acetylsalicylic acid in normal ...

On-line computerized vectorcardiography (cVCG) is increasingly being used for continuous monitoring of myocardial ischemia, however, little is known about factors other than ischemia causing electrocardiographic abnormalities. This paper describes how three important cVCG parameters, STC-VM, ST-VM and QRS-VD, are affected by different body positions, myocardial ischemia, contrast injection and increasing ...

Sevoflurane is associated with less tachycardia and coronary vasodilation than isoflurane and thus might be associated with less myocardial ischemia. This multicenter study examined the incidence of myocardial ischemia and adverse cardiac outcomes in adults (40-87 yr) with cardiac disease having elective noncardiac surgery. Patients were randomized to receive either ...

INTRODUCTION: This study was designed to determine the role of increased extracellular potassium [K+]e on action potential duration (APD) in the in situ porcine heart during acute regional no-flow ischemia. METHODS AND RESULTS: In open chest, anesthetized swine, an arterial shunt from the carotid artery to the mid-left anterior descending ...

Chlorinated hydrocarbons are well known to produce ventricular arrhythmias because of myocardial sensitization to endogenous catecholamines, but cases of myocardial ischemia have not been described frequently. We report 2 cases of myocardial ischemia after exposure to chlorinated hydrocarbons. The first patient developed an asymptomatic myocardial infarction after inhalation of 1,1,1-trichloroethane ...

During myocardial ischemia, the extracellular potassium concentration increases in a triphasic pattern, an initial early increase, a constant phase, and a late increasing phase. The aim of this study was to determine whether diltiazem inhibits the late increasing phase by maintaining glycolytic adenosine triphosphate (ATP) synthesis in ischemic myocardium. The ...

We report two patients with exertional headaches beginning with vigorous exercise and relieved by rest. Neurologic evaluation and neuroimaging were normal in both. During exercise stress testing, the onset of the patients' typical headaches correlated with ECG changes indicative of myocardial ischemia. In both patients coronary angiography revealed three-vessel disease, ...

To determine the frequency, duration, magnitude, and possible adverse effects of ischemia during intracoronary ultrasonography, real-time standard 12-lead electrocardiograms were recorded before, during, and after ultrasonography. Ischemia was defined as new-onset ST segment deviation of > or = 1 mm in one or more leads, measured at J + 80 ...

Myocardial ischemia occurs frequently during daily life and has a circadian pattern similar to that reported for myocardial infarction and sudden death. Because of the increased risk of myocardial ischemia in the morning hours, it has been suggested that the administration of anti-ischemic medication before bedtime may be more effective ...

Polyvalent intravenous immunoglobulin (IVIg) is considered to be standard therapy for a variety of autoimmune and idiopathic disorders. Several reports have emphasized the temporal association between administration of IVIg and thrombotic events. Recent experience with a patient who suffered a large myocardial infarction shortly after receiving IVIg led the authors ...

BACKGROUND: The myocardium bordering a healed infarction undergoes electrophysiological and autonomic neural derangements that may interact with a new ischemic episode to promote arrhythmias. Therefore, peri-infarction ischemia may be more arrhythmogenic than ischemia at a distance from the infarct zone, but this is not known. METHODS AND RESULTS: Forty-two anesthetized ...

OBJECTIVES: The purpose of this study was to assess whether the severity of myocardial ischemia would be attenuated by repeated daily ischemic episodes, recorded by ambulatory electrocardiographic monitoring (AEM). BACKGROUND: Repetitive ischemic episodes induced by brief coronary occlusions in animal experiments and in humans during balloon coronary angioplasty produce preconditioning. ...

A major reason for the relatively low sensitivity of Holter electrocardiography (ECG) for detecting ischemia is that the sensitivity of bipolar leads used for Holter ischemia monitoring has not been systematically evaluated, making lead selection difficult. Therefore, this study evaluated the sensitivity of 6 bipolar Holter leads for detecting ischemia ...

Persistently ischemic myocardium exhibits increased glucose uptake which may contribute to the preservation of myocardial function and viability. Little is known about the specific molecular events which are responsible for this increase in uptake. Therefore, we investigated whether myocardial ischemia induces the gene expression of the major cardiac facilitative glucose ...

Coronary angioscopy was used to elucidate the underlying substrate of the culprit lesion in 20 patients with postinfarction ischemia and in 19 patients with other types of unstable angina. Plaque characteristics were similar in both groups, but red thrombi and occlusive thrombi were more frequently seen in patients with postinfarction ...

Cardiac ischemia is associated with an impairment in long-chain fatty acid metabolism. We studied carnitine palmitoyltransferase (CPT) in left ventricular biopsies of 6 transplant recipients with ischemia due to atherosclerosis, 4 patients with dilated cardiomyopathy, and 5 donor hearts. Total CPT activity was not significantly different between the three groups ...

This article has traced the evolution of our knowledge of mesenteric ischemia from the initial stage of recognition of the condition and its manifestations, through the phase of treatment after the fact-resection of gangrenous intestine, to our present-day attempts to diagnose and treat the ischemic episode before death of the ...

It has been shown that brief episodes of myocardial ischemia can render the heart more resistant to a prolonged subsequent ischemic episode. This phenomenon, called "preconditioning," has been described in human beings during coronary angioplasty with the use of clinical, electrocardiographic (ECG), or metabolic parameters. The goal of this study ...

OBJECTIVES: This study was undertaken to better understand the functional and prognostic significance of silent relative to symptomatic ischemia. BACKGROUND: Previous studies have reached conflicting conclusions as to whether painless ischemia identified during noninvasive cardiac testing is related to a lesser extent of myocardial ischemia or a different prognosis than ...

BACKGROUND: Transient ischemia in stable coronary disease peaks in the morning, reflecting increased myocardial oxygen demand and coronary vasomotor tone after walking. In acute coronary syndromes, however, ischemia may result from transient thrombus formation or coronary spasm at the site of a ruptured plaque. We report on the pathophysiological mechanisms ...

The protective effect of prior ischemia on focal cerebral infarction produced by permanent middle cerebral artery (MCA) occlusion was studied in a gerbil model. Forebrain ischemia for 2 and 5 minutes at an interval of 48 hours was used as the prior ischemic insult. Forty-eight hours after the second forebrain ...

BACKGROUND: Mivazerol hydrochloride is a new alpha 2-adrenoceptor agonist. In vitro and animal studies have demonstrated both sympatholytic and antiischemic properties. To evaluate the safety and efficacy of mivazerol in patients during perioperative stress, this multicenter phase II clinical trial studied hemodynamic stability and myocardial ischemia in patients with coronary ...

INTRODUCTION: Vasodepressor syncope is a common cause of syncope, but the initiating event that triggers the vasodepressor response remains incompletely understood. Although ischemia due to acute right coronary occlusion may precipitate hypotension and bradycardia through the Bezold-Jarisch reflex, an ischemic precipitant for the common vasodepressor faint has not been previously ...

Arrhythmias are caused by the interdependent processes of change in energy metabolism and alterations in sarcolemmal ion gradients that occur during ischemia. Depletion of energy metabolites and increased proton concentrations in ischemic heart may underlie the observed phenomena of reduced contractile force and also of malignant ventricular arrhythmias that can ...

The Björk-Shiley convexo-concave artificial heart valve has a significant risk of failure which is often fatal.Elective explantation has a mortality of approximately 5%. Follow-up studies provide the basis for clinical decision making whether or not to explant the valve. So far, the contribution of technical, organizational, ethical, and professional considerations ...

Silent myocardial ischemia, whether it occurs at rest or during exercise, is associated with an unfavorable prognosis and may lead to sudden cardiac death. Agents used to treat silent myocardial ischemia have included nitrates, beta-blockers, and calcium antagonists (CAs). Despite treatment with traditional anti-ischemic agents, studies have shown that up ...

The effect of myocardial ischemia on mitochondrial DNA (mtDNA) structure and the presence of specific mtDNA deletions was determined using the model of Ameroid constriction of canine coronary arteries. The incidence of specific deletions was high in both the endocardial and epicardial tissues perfused by the occluded vessel as compared ...

Exercise testing (EX) and Holter ECG (DCG) were performed consecutively in 52 patients with ischemic heart disease. A total of 100 episodes of myocardial ischemia (IE) were recorded during DCG in 30 patients, who constituted 94% of the patients with myocardial ischemia under 6 metabolic equivalents (METs) during EX. A ...

BACKGROUND: Lipid-lowering therapy reduces cardiac morbidity and mortality. Less is known about its potential anti-ischemic effect. METHODS AND RESULTS: In a 2-year prospective randomized placebo-controlled study, the effect of pravastatin 40 mg on transient myocardial ischemia was assessed. Forty-eight-hour ambulatory ECGs with continuous ST-segment analysis were performed in 768 male ...

BACKGROUND: Most new perioperative myocardial ischemic episodes occur in the absence of hypertension or tachycardia. The ability of alpha 2-adrenoceptor agonists to inhibit central sympathetic outflow may benefit patients with coronary artery disease by increasing the myocardial oxygen supply and -demand ratio. METHODS: A randomized double-blind study design was used ...

We present a case in which an anemic patient with religious objections to blood transfusion experienced three episodes of severe myocardial ischemia during the perioperative period. The first episode of ischemia was successfully treated by discontinuing isoflurane and resolving the hypotension. The second and third episodes were successfully treated by ...

We previously showed that generation of reactive oxygen species during myocardial ischemia and reperfusion stimulates cardiac sympathetic afferent nerve endings. We hypothesized that, in this feline model of brief ischemia and reperfusion, HO. is produced during ischemia and the rate and concentration of production of HO.during reperfusion is dependent on ...

Recent research reveals that some patients with a normal coronary arteriogram present with myocardial ischemia in the late stages of Kawasaki disease (KD). The present paper reports a patient who developed ventricular arrhythmia and possible myocardial ischemia in the late stages of KD but whose coronary arteriogram was normal. The ...

Ninety four patients undergoing transurethral resection of the prostate underwent Holter electrocardiographic monitoring pre- and postoperatively. There was no difference in silent myocardial ischaemia incidence or load between the spinal (n = 60) and the general anaesthesia (n = 34) groups. Ischaemic heart disease and a higher Detsky score both ...

We investigated myocardial ischemia and old myocardial infarction noninvasively using signal-averaged electrocardiographic late potentials (LPs) in patients with Kawasaki disease. Patients were divided into 4 groups: a noncoronary artery lesion group (n=136), a coronary artery lesion group (without myocardial ischemia and an old myocardial infarction; n=33), an ischemia group (n=16), ...

The effect of chronic hypoxia on neonatal myocardial metabolism remains undefined. With a new neonatal piglet model, we determined changes in myocardial metabolism during global ischemia after chronic hypoxia. Five-day-old piglets (N = 30) were randomly assigned to two groups and exposed to an atmosphere of 8% oxygen or to ...

4ACKGROUND. Non-heart-beating donors (NHBDs) have been proposed for the critical shortage of donors for cardiac and pulmonary transplantation. We determined the effects of prearrest hypoxia and postarrest warm ischemia on cardiac and pulmonary allografts procured from NHBDs undergoing hypoxic arrest. METHODS. Rabbit hearts and lungs were procured from separate donors ...

Insulin-dependent diabetic (IDDM) subjects with microalbuminuria have an increased long-term risk of overt cardiovascular disease; however, the early exposure to cardiovascular risk factors may increase their predisposition to current silent myocardial ischaemia. The frequency of silent myocardial ischaemia detected by stress echocardiography and electrocardiography was significantly greater in 32 asymptomatic ...

Plasma endothelin (ET) is increased in association with myocardial infarction. The aim of the present study was to get insight into the mechanisms behind this ischemia-induced increase in plasma ET. Since granulocytes increase ET production in vitro, we examined to what extent inhibition of granulocyte-derived proteases could reduce the increase ...

OBJECTIVES: This study sought to compare the circadian variations in transient ischemic activity, mean heart rate and ischemic threshold between women and men with coronary artery disease. BACKGROUND: There is a circadian variation in ischemic activity, onset of myocardial infarction and sudden cardiac death in patients with coronary artery disease, ...

Many methods for mapping ischemic myocardial regions by functional analysis have been suggested. However, the complicated relationship between myocardial function and perfusion, and the inherent limitations of the imaging techniques used, have led to a generally low mapping accuracy. We show herein, that highly accurate mapping can be obtained by ...